1649658204 NPI number — HAMLET KARAPETIAN DENTAL CORP.

Table of content: (NPI 1649658204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649658204 NPI number — HAMLET KARAPETIAN DENTAL CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMLET KARAPETIAN DENTAL CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649658204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1338 SANTA ROSA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN LUIS OBISPO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-543-8440
Provider Business Mailing Address Fax Number:
805-928-6788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 N COLLEGE DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
SANTA MARIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-925-6039
Provider Business Practice Location Address Fax Number:
805-928-6788
Provider Enumeration Date:
05/14/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KARAPETIAN
Authorized Official First Name:
HAMLET
Authorized Official Middle Name:
Authorized Official Title or Position:
DENTIST OWNER
Authorized Official Telephone Number:
805-928-6776

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  53228 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 53228 . This is a "DENTIST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com